Costs, Coverage, and Complications: Disparities in Inpatient Alloplastic Facial Implants in the US Healthcare System.

This study investigates how socioeconomic status, insurance type, and geography shape access to inpatient synthetic facial implant surgery in the United States. Using HCUP-NIS data from 2016 to 2020 (n=68), the authors show that lower-income patients are more likely to be publicly insured, experience significantly longer hospital stays, and are underrepresented in cosmetic and gender dysphoria-related procedures, while higher-income, urban patients more often self-pay for elective implants clustered in large metropolitan and Pacific regions. Despite low overall complication rates, inpatient admissions are associated with high costs, and rural and low-income patients face pronounced barriers to care, particularly for facial feminization surgery. This work highlights the need for broader outpatient data capture, qualitative research among marginalized groups, and standardized insurance coverage policies to promote equitable, cost-effective access to functional and aesthetic facial implant procedures.